Health economics perspective of fesoterodine, tolterodine or solifenacin as first-time therapy for overactive bladder syndrome in the primary care setting in Spain

Sicras‐Mainar, Antoni; Rejas, Javier; Navarro‐Artieda, Ruth; Aguado-Jodar, A.; Ruiz-Torrejón, A.; Ibáñez-Nolla, Jordi; Kvasz, Marion

doi:10.1186/1471-2490-13-51

Cited by 10 publications

(3 citation statements)

References 39 publications

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“… 25 The economic superiority of fesoterodine compared with other antimuscarinic drugs available in our health care setting has also been shown in conditions of routine or real-life practice, indicating that fesoterodine can lead to health care savings in the treatment of OAB, which is NHS-funded, and offsetting its higher pharmacological cost with less use of health care resources, such as medical visits, absorbents, or concomitant medication related to OAB (antidepressants, anxiolytics, etc), in patients of any age and in vulnerable subjects. 30 – 32 However, none of the above economic evaluations has addressed the cost-effectiveness of fesoterodine in flexible doses, which allows for two different dosages: a rapid scaling to high doses or the standard scaling according with the recommendation in the fesoterodine summary of product characteristics. In our study, when flexible doses of fesoterodine were used in newly diagnosed patients, fast scaling to high doses proved to be a cost-effective treatment option in most of the situations analyzed according to the current recommendations in our health care setting.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Peral

Sánchez-Ballester

García-Mediero

et al. 2016

CEOR

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ObjectiveTo carry out cost-effectiveness analysis from the Spanish National Health System perspective, of treating overactive bladder (OAB), in newly diagnosed patients with two flexible doses of fesoterodine in routine clinical practice.Patients and methodsEconomic evaluation of flexible-dose fesoterodine in newly diagnosed patients, including two treatment groups: standard escalating from 4 to 8 mg or fast escalating to 8 mg. Costs were estimated from health care resources utilization related to OAB, and were expressed in 2015 Euros. Quality-adjusted life-years (QALYs) were obtained from overactive bladder questionnaire-short form. Univariate and probabilistic sensitivity analyses were carried out.ResultsThree hundred and ninety symptomatic OAB patients treated with fesoterodine and newly diagnosed (141 in fast escalating group and 249 in standard escalating) were analyzed. Adjusted health care total costs were not statistically different; difference −€4.1 (confidence interval: −153.3; 25.1) P=0.842. QALYs were higher in fast escalating to high dose vs standard escalating group, resulting in a cost of −€16,020/QALY gained for fast escalating vs standard escalating group.ConclusionWhen the cost-effectiveness threshold is set at a maximum value of €30,000/QALY gained, fesoterodine fast escalating group was cost-effective vs standard escalating group 67.6% of the time. The treatment with fesoterodine, in female patients newly diagnosed, fast escalating to 8 mg was a cost-effective option relative to escalating traditionally from 4 to 8 mg, in the management of OAB in routine clinical practice, from the Spanish National Health System perspective.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Peral

Sánchez-Ballester

García-Mediero

et al. 2016

CEOR

Self Cite

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“…Furthermore, its low dose and short biological half-life make it an ideal candidate to formulate a sustained release minitablet. 5 , 6 Mock et al. observed that Fesoterodine is an antimuscarinic agent with a unique pharmacokinetic profile.…”

Section: Introductionmentioning

confidence: 99%

Formulation and evaluation of pH activated dosage form as minitablets in capsule for delivery of fesoterodine

Syed¹,

Rathi²,

Gawale³

et al. 2022

Journal of Taibah University Medical Sciences

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Objectives In the present study, an attempt is made to develop novel multifunctional sustained-release minitablets in a capsule system by film coating Fesoterodine for the treatment of urinary incontinence (increased urinating frequency). Methodology The direct compression technique was used to formulate the minitablets, and coating was applied using hydroxypropyl methylcellulose (HPMC) phthalate. The pre-formulation study was performed using tools like differential scanning calorimetry (DSC), infrared spectroscopy (IR) and post-formulation parameters such as hardness, thickness, weight variation, uniformity, and drug release. Drug release kinetics were studied for the formulations F1–F11. Results All the pre- and post-formulation parameters were found to be within the limits. F1 and F2 result in burst release of the drug within 30 minutes. For the F3, F4, and F5 formulations, HPMC phthalate-coated minitablets show almost 100% drug release in 3, 4, and 5 hours, respectively. F6, F7, and F8 (2.5%, 5%, and 10% formaldehyde-coated minitablets, respectively) show drug releases in the small intestine, and the release was prolonged for 24 hours, whereas F9, F10, and F11 (2.5%, 5%, and 10% glutaraldehyde-coated minitablets, respectively) release in the small intestine, but drug release takes more than 20 hours. Conclusion Film-coated minitablets were satisfactorily developed in terms of various post-compression parameters like hardness, thickness, friability, weight variation, and content uniformity. IR and DSC studies revealed no significant drug excipient interactions. HPMC phthalate-coated minitablets released in the buffer, and it was supposed that the drug releases in the intestine, which leads to better absorption and follows Korsmeyer-Peppas release kinetics.

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“…When this voiding dysfunction is consistent with OAB, it is termed neurogenic overactive bladder (N-OAB) [5]. OAB is a common chronic condition with its prevalence increases with age in both women and men, and it should not be considered as part of normal aging process [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Pathways of Third-Line Treatment of Overactive Bladder in the Elderly

Farhan

Ghoniem

2015

Curr Bladder Dysfunct Rep

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Overactive bladder (OAB) is a syndrome of urinary urgency, usually accompanied by frequency, nocturia, and sometimes urinary urgency incontinence. There are many guidelines for the OAB treatment which are constructed on a stepwise fashion starting from the least invasive to the more invasive therapy. The emergence of third-line therapy (AUA/ SUFU guidelines) has resulted in significant decrease of more invasive surgery and improved patients' quality of life. The aim of a clinical pathway is to improve the quality of care, reduce risks, increase patient satisfaction, and increase the efficiency in the use of resources. The available options for the third-line OAB treatments include intravesical injection of botulinum toxin A, percutaneous tibial nerve stimulation (PTNS), and sacral nerve stimulation (SNS). The available evidence confirms that all three treatment approaches are well tolerated and effective, although only botulinum toxin type A (BoNTA) and SNS can achieve nearly a cure of urgency urinary incontinence (UUI). The choice among the different third-line treatment depends on patient preference, availability, and local expertise. The application of these pathways can improve incontinence care by letting physicians adequately communicate with patients and select individualized therapy at an early stage especially for elderly patients.

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Health economics perspective of fesoterodine, tolterodine or solifenacin as first-time therapy for overactive bladder syndrome in the primary care setting in Spain

Cited by 10 publications

References 39 publications

Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Formulation and evaluation of pH activated dosage form as minitablets in capsule for delivery of fesoterodine

Clinical Pathways of Third-Line Treatment of Overactive Bladder in the Elderly

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